Personal Accident Insurance

Effective Date: On the date accepted and validated by the Company.

The United Coconut Planters Life Assurance Corporation (herein called the Company) certifies that the person whose name
appears below is insured for the following benefits:

Part I – Accidental Death (Sum Assured: P1,000,000.00) with Burial Benefit due to Any Cause (Sum Assured: P50,000.00).
The Company will pay the percentage of the Sum Assured less any amount paid under Part II – Accidental Disablement,
if a member dies due to injury sustained within one hundred eighty (180) days after the date of accident.

Part II – Accidental Disablement or Loss of Use The Company will pay the percentage of the Sum Assured according to
the Benefit Schedule if the Insured as a result of injury, incurs any of the losses listed in the Benefit of Schedule,
within one hundred eighty (180) days after the date of accident.

Part III – Burial Benefit due to Any Cause (Sum Assured: P50,000.00) The Company will pay the Sum Assured equivalent to
Burial Benefit at the time of his death provided that the member is in good health and actively at work upon inception of
insurance coverage.



INSURED – Each eligible member accepted by the Company for insurance coverage under this Policy.

INJURY – Wherever used in this Policy, means accidental bodily injury occurring while this Policy is in force resulting
in loss covered by the Policy.

LOSS – total permanent loss of the use of a body part shall be treated as loss of such body part.

ACTIVELY AT WORK – A member shall be considered ‘actively at work’ for insurance purposes if he performs
all the usual and normal activities of life and if at any time he is neither (i) hospital confined, nor (ii) disabled to
a degree that he could not then have reported to a place of employment outside of his home and performed
all of the usual and customary duties of his occupation on a regular, full-time basis.

No payment shall be made for any loss resulting from or is caused directly or indirectly in whole or in part
by any of the following occurrences:

1. bodily or mental infirmity, hernia, ptomaines, or bacterial infection (except pyogenic infection which
shall occur with and through an accidental cut or wound) or disease or sickness of any kind;
2. poison, gas or fumes (voluntarily or involuntarily taken), atomic explosions, nuclear fission, or radioactive gas;
3. self-destruction or any similar attempt whether sane or insane, except as provided for in Section 183 of the Amended Insurance Code or in the case of suicide where Suicide Clause Provision shall apply;
4. participation in any brawl;
5. Any injury suffered or as a result of any of the following:
     a. while under the influence of alcohol or drug
     b. while being a passenger of a driver under the influence of alcohol or drug
     c. any violation of the law or resistance to arrest by the insured
     d. murder or assault provoked by the insured
     e. strike, riot, civil commotion, insurrection or war, declared or undeclared, revolution or any war-like      operations, or while under orders for war-like operations or restoration of public order or any act incident thereto
     f. any acts of terrorism or sabotage
     g. where there is no visible external wound, except drowning or internal injury revealed by autopsy;

7. pregnancy, childbirth, miscarriage or abortion or any complications of pregnancy or childbirth; entering, operating, or servicing, ascending from or with any aerial or marine device or conveyance except while travelling as a passenger in an aircraft or marine transportation operated by a commercial passenger airline or shipping line on a scheduled air or sea service over an established passenger route;
8. any hazardous sports;
9. medical, surgical or dental treatment of any kind, or the administration, injection, or taking accidentally or otherwise, of any drug, sedative or other medication except when such treatment or medication is required as a result of an accident;
10. any loss in which the proximate cause was the Insured’s attempt at, or commission of or willful participation in any act or crime punishable under the Revised Penal Code of the Philippines or any other statute except crimes of reckless imprudence as defined in Article 365, or similar laws, of any country in which the crime was attempted or committed, or resistance to lawful arrest;
11. congenital anomalies or conditions arising therefrom.

The insurance will not apply to:
1. individuals who are: (a) mentally incompetent; (b) not free from physical deformity; (c) permanently disabled
2. individuals engaged in the following activities: aqualung diving, boxing or other combat sport, climbing, flying except air travel in a commercial flight, football, hang-gliding, hunting, ice hockey, motor competitions, parachuting, hurling, polo, pot-holding, power boating, racing, show jumping, skydiving, use of woodworking machinery, water-ski-jumping and tricks, winter sports, wrestling, yachting beyond 5 kilometers of a coastline; Other activities not specified above but which present hazards of similar nature to any of the above activities shall likewise be excluded;

3. individuals while engaged in any duty directly or indirectly pertaining to the following occupations: acrobats, stuntmen, army personnel (members of the Armed Forces), asylum attendants, automobile racing driver, secret service personnel, aviators, boiler men, customs personnel, detectives, divers, explosive makers, handlers and custodians, ship’s crew, sailors, deckhands and seamen, steeple jacks, underground workers, miners, window cleaners, woodworking and metalworking machinist, loggers, policemen, security guards, professional athletes, professional entertainers and musicians, sawmill workers, cablemen and linemen, structural steel workers; Other occupations not specified above but which present hazards of similar nature to the above occupations shall likewise be excluded;
4. Overseas Filipino Workers (OFW) and Barangay Tanods or other politically exposed persons.


Benefits payable upon the death of the insured shall be paid to the designated Beneficiary. All other benefits shall be paid to the insured.
The Statement of Insurance Coverage is furnished in accordance with and subject to the terms of the group policy. The insurance is effective only if the insured is eligible for insurance and becomes and remains insured in accordance with the provisions, terms and conditions of the Policy. The insured shall have the right to examine the Policy on file with the Company upon presentation of proof of coverage, which policy shall govern in the interpretation of the Statement of Insurance Coverage.
If due to the misstatement of age, misrepresentation, concealment or any other reason, this Statement of Insurance Coverage is issued to any insured or insureds who are otherwise disqualified for insurance coverage under the Policy, the Company’s liability shall be limited to a return of premiums, if any.
The insurance under this Statement of Insurance Coverage shall be for one (1) year coverage commencing on effective date. To confirm coverage, you may call the Group Marketing Division of COCOLIFE at telephone number: (02) 8-812-9015 local 213.

Close Bitnami banner